Document Detail

End-to-end versus end-to-side stapled anastomoses after anterior resection for rectal cancer.
MedLine Citation:
PMID:  18985633     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: Sphincter-saving procedures for resection of mid and, in some cases, of distal rectal tumors have become prevalent as their safety have been established. Increased anastomotic leak rate, associated with the type of anastomosis and the distance from the anal verge, has been reported. To compare surgical outcomes of end-to-end and end-to-side anastomosis after anterior resection for T1-T2 rectal cancer. METHODS: During the study period, a total of 298 rectal cancer patients were treated. Patients with T1-T2 rectal cancer (i.e., tumor level < or =15 cm from the anal verge) fit for surgery were asked to participate in the study. Patients were randomized to receive either an end-to-end anastomosis or an end-to-side anastomosis using the left colon. Surgical results and complications were recorded. RESULTS: Seventy-seven patients were randomized. Thirty-seven end-to-end anastomoses and 40 end-to-side anastomoses were performed. Anastomotic leakage after end-to-end anastomosis was 29.2%, while after end-to-side anastomosis was 5% (P = 0.005). In the end-to-end group 11 patients had anastomotic leaks: nine patients needed a re-intervention with colostomy creation subsequently closed in seven cases. Two patients of the end-to-side group experienced anastomotic leakage and were successfully treated conservatively. CONCLUSIONS: Regarding postoperative surgical complications, end-to-side anastomosis is a safe procedure.
Giuseppe Brisinda; Serafino Vanella; Federica Cadeddu; Ignazio Massimo Civello; Francesco Brandara; Casimiro Nigro; Pasquale Mazzeo; Gaia Marniga; Giorgio Maria
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of surgical oncology     Volume:  99     ISSN:  1096-9098     ISO Abbreviation:  J Surg Oncol     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-22     Completed Date:  2009-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0222643     Medline TA:  J Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  75-9     Citation Subset:  IM    
Department of Surgery, Catholic University Hospital Agostino Gemelli, Rome, Italy.
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MeSH Terms
Anastomosis, Surgical / adverse effects,  methods*
Middle Aged
Rectal Neoplasms / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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